Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.20 / $4,420.00 / $16,125.00	Facility		$322.20	$4,420.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $165.97 / $182.61 / $1,311.81	Facility	54	$165.97	$182.61	$1,311.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.43 / $254.57 / $771.00	Professional		$206.43	$254.57	$771.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,988.00 / $4,542.00 / $9,119.00	Facility		$1,988.00	$4,542.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $262.27 / $343.76 / $660.94	Professional		$262.27	$343.76	$660.94
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $184.33 / $258.39 / $576.16	Professional		$184.33	$258.39	$576.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $253.20 / $453.49	Facility		$56.00	$253.20	$453.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.28 / $330.85 / $703.97	Professional		$237.28	$330.85	$703.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $148.06 / $333.71 / $450.51	Professional		$148.06	$333.71	$450.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $279.69 / $378.97 / $661.18	Professional		$279.69	$378.97	$661.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,264.28 / $1,408.57	Facility		$55.00	$1,264.28	$1,408.57
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $871.06 / $986.00 / $986.00	Facility	54	$871.06	$986.00	$986.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,957.12 / $2,195.76 / $2,561.33	Professional		$1,957.12	$2,195.76	$2,561.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $265.32 / $357.96 / $489.29	Facility		$265.32	$357.96	$489.29
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $550.54	Facility	54	$314.41	$314.41	$550.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $247.27 / $348.07 / $718.56	Professional		$247.27	$348.07	$718.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $831.85 / $831.85 / $919.61	Professional		$831.85	$831.85	$919.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $301.13 / $414.05	Professional		$165.83	$301.13	$414.05
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $6,323.00	Facility		$548.00	$1,533.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $211.92 / $271.95 / $610.46	Professional		$211.92	$271.95	$610.46